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Improved PSA Tests May Better Determine Prostate Cancer Risk

New refinements better measure risk versus actual evidence of disease

January 22, 2009

• Study Links Prostate Cancer to Single Rogue Cell • PSA Testing May Be Unnecessary for Some Older Men • Compound Can Identify Prostate Cancer • Improved PSA Tests May Better Determine Prostate Cancer Risk • Vitamins Don't Cut Prostate Cancer Risk • Aspirin May Lower PSA Levels in Men • FDA Approves New Overactive Bladder Drug • New Prostate Surgical Techniques Often "Over-Promoted" • Feds Approve Drug for Enlarged Prostate • New Prostate Cancer Treatment Shows Promise • Broccoli Reduces Prostate Cancer Risk, Study Finds • Celebrex-Lipitor Combo May Halt Prostate Cancer • Exercise May Speed Prostate Tumor Growth • Soy Compound May Halt Spread of Prostate Cancer • Obesity Linked to Higher Prostate Cancer Mortality • Red Wine May Fight Prostate Cancer • Enlarged Prostate Doesn't Mean Cancer • Hopkins Researchers Claim Better Blood Test for Prostate Cancer • Severe Form of Enlarged Prostate Disease Discovered • Tomato-Broccoli Combo Can Help Shrink Prostate Cancers • Weight Gain Increases Risk of Dying from Prostate Cancer • Smoking Linked to Complications in Prostate Cancer Treatment • Newer Approach Urged in Screening for Aggressive Prostate Cancer • Aspirin May Prevent or Delay Enlarged Prostate • Hopkins Researchers Find Better Blood Test for Prostate Cancer • Prostate Radiation May Cause Problems Later • New Test Detects Prostate Cancer Spread Earlier • Castration May Be Advised in Advanced Prostate Cancer • Radiation Therapy May Be Best for Younger Prostate Cancer Patients • Study Recommends More Prostate Biopsies • Delayed Surgery May Be OK for Some Prostate Cancer Patients • Study: PSA Test Doesn't Improve Prostate Cancer Survival Rate • Prostate Cancer Genes Identified • Annual Prostate Cancer Screening Test Appears to Save Lives • FDA Panel Rejects Prostate Cancer Pill • PSA Test Still Useful, Hopkins Study Finds • No "Normal" PSA Level: Study • New Prostate Cancer Test Shows Promise • Lifestyle and Diet May Stop or Reverse Prostate Cancer Progression

A prostate-specific antigen (PSA) test can't diagnose prostate cancer, but results indicate the risk of cancer. According to the January issue of Mayo Clinic Health Letter, recent fine-tuning of this test gives doctors better information to help determine cancer risk.

PSA is a substance produced in the prostate gland. Normally, a small amount of PSA enters the bloodstream. A higher amount or an abrupt rise in PSA levels can indicate a problem, possibly cancer.

However, PSA results aren't specific; that is, a high PSA indicates increased risk of cancer, but not the presence of cancer. Nor does the risk information indicate how quickly a potential cancer might be growing.

Most prostate cancers are slow growing. For older men, a slow-growing cancer may not cause symptoms and may never need treatment.

While not perfect, annual PSA testing, along with a digital rectal exam, remains the best option to detect prostate cancer early. Ask your physician about these recent refinements in PSA testing:

• PSA velocity: This charts the change in PSA levels over time. PSA levels tend to increase more quickly in men who have prostate cancer than those with other prostate conditions. For example, an enlarged prostate, a benign condition, also can be indicated by increased PSA levels. Velocity testing is a reason why annual or more frequent PSA measures are important, because it shows subtle changes that can lead to early intervention and better outcomes.

• PSA doubling time: Similar to PSA velocity, this test looks at how quickly PSA levels double. The risk of prostate cancer is particularly acute when PSA levels double within 18 months.

• PSA density: Using ultrasound imaging, the physician determines the size of the prostate gland. With this information, the physician can evaluate the PSA number based on the gland's size. For example, larger prostate glands produce more PSA.

• Free versus total PSA: This test separates PSA in the bloodstream into two types. Bound or total PSA is attached to certain blood proteins, and free PSA isn't. Prostate cancer is more likely to result from bound PSA. So, a lower percentage of free PSA compared with bound indicates an increased likelihood of cancer.

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